title: Use of pentastarch solution in the treatment of patients with hemorrhagic hypovolemia: randomized phase II study in the emergency room.
abstract: This study evaluates the hemodynamic effects of the administration of 10% pentastarch solution (PS) during the initial treatment of hypovolemia in trauma patients. This prospective randomized phase II study included trauma patients admitted to the emergency room with hemorrhagic hypovolemia: systolic blood pressure (SBP) < 90 mmHg. Upon admission, the patients were randomized to receive 10% PS (n = 12) or isotonic 0.9% NaCl solution (IS) (n = 11), infused intravenously in 250-ml boluses, repeated until SBP > 100 mmHg. Blood pressure, infused volumes necessary to maintain SBP, and overall survival rates were determined and compared between groups. SBP increased significantly following either IS (from 64.4 +/- 9.2 mmHg to 111.1 +/- 6.3 mmHg), or PS (from 63.7 +/- 10.6 mmHg to 108.1 +/- 9.8 mmHg) when compared to admission values (p < 0.05). Endovenous volumes infused were greater (p = 0.001) in IS patients (1420 +/- 298 ml) than in PS patients (356 +/- 64 ml). No blood was transfused into PS patients, compared to 370 +/- 140 ml of red blood cells transfused into IS patients (p = 0.015). Mortality rates were similar in the two groups (p = 0.725). We concluded that PS is a safe, efficient method for inducing hemodynamic recovery of hypovolemic trauma patients, with a clear reduction in the intravenous volumes required for acute resuscitation.
authors.affiliation: Department of Thoracic Surgery, Hospital AC Camargo, São Paulo, Brazil.
authors.forename: R N
authors.initials: RN
authors.lastname: Younes
authors.forename: K C
authors.initials: KC
authors.lastname: Yin
authors.forename: C J
authors.initials: CJ
authors.lastname: Amino
authors.forename: M
authors.initials: M
authors.lastname: Itinoshe
authors.forename: M
authors.initials: M
authors.lastname: Rocha e Silva
authors.forename: D
authors.initials: D
authors.lastname: Birolini
mesh_terms: D000293:Adolescent; D000328:Adult; D001810:Blood Volume; D004630:Emergencies; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011446:Prospective Studies; D012996:Solutions; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012996:Solutions